DESCRIPTION: This proposed 5-year research project builds on previous work done in the Consumer Assessment of Health Plans Study (CAHPS (R) I), funded by AHRQ from 1995 to 2001. The project has 4 primary objectives: 1) To conduct a 5-year project of research designed to advance knowledge about effective reporting of health plan and physician performance for consumers, purchasers, children with special health care needs, and other audiences; 2) To evaluate the usefulness of CAHPS (R) survey and reports for quality improvement; 3) To derive new survey items and reports for the institutional setting, group practice, individual physicians, PPOs, and persons with mobility impairments; and 4) To assess the cultural comparability of CAHPS (R) data by race/ethnicity and language. The project also will maintain survey and reporting products developed in CAHPS (R)I. The study will consist of a program of systematic research to advance the state of science on reporting, including development and testing of reporting templates for providers of health care, children with special health care needs, person with mobility impairment, and non-English languages. In addition, the investigators will collect information on existing activities and methods for quality improvement (QI) by health plans, physician groups and individual providers, develop survey items to facilitate QI efforts, design performance reports, develop QI implementation methods and tools, and conduct QI demonstrations with the CAHPS (R) survey and targeted item set. Finally, the investigators will finalize the group level and nursing home CAHPS (R) survey instruments, develop targeted items for persons with mobility impairment and PPO settings, develop an individual provider level CAHPS (R) survey, evaluate the need for specific dialects for the Spanish CAHPS (R) survey, translate the core survey into additional languages, assess the cultural comparability of the CAHPS (R) survey in different subgroups, explore new data collection techniques, and evaluate new methods for scoring CAHPS (R) survey items and composites.